Common biomechanical problems with runners – flexibility

Stretching running physiotherapy

Last week’s blog looked at strength in key muscle groups for runners. This blog is highlighting areas of the body where flexibility is useful at preventing pain associated with running. There has been a lot of research on muscle length / flexibility relative to preventing injuries and the summary is commonly that it doesn’t help. However sometimes the research doesn’t give us the full picture on how to help an individual with pain and that is where having an experienced physio counts. Helping runners return to exercise after pain or injury results in a wealth of experience based knowledge. In relation to muscle length it is that if you don’t have the mobility in the correct places it can lead to injury. An obvious example is a hurdler who tightens up in the hamstring and lacks the flexibility to get the front leg over the bar.  The key area for everyday runners to maintain flexibility is in the front of the hip.

The front of the hip / hip flexors includes 3 muscles, one of which is the TFL (tensor fascia lata) that connects to the ITB (iliotibial band). One example of a common runner’s problem is not having enough hip flexor length which can impair the buttock (gluteal) muscle function and lead to the TFL muscle working harder to stabilise the pelvis whilst running. This can then lead to ITB tightness and pain in runners. Another example is tightness in the hip flexors leading to an increased arch in your back. When this combines with the glut’s switching off hip or back pain are common.

hip flexor tightness and low back pain
Tight hip flexors

Correctly stretching your hip flexors should be comfortable. It is possible to make short lasting improvements in muscle length so if you are tight you need to stretch before you run (despite some research assumptions!). Don’t forget to control the pelvis when stretching.

hip flexor stretch
hip flexor stretch – pelvic tilt / roll

The best plan is if you have pain then get one of the experienced NU Moves physio’s to assess and determine if that’s what you need to get you back to running pain free.

Running biomechanics and muscle strength

Running physiotherapy injury

 

Biomechanics refers to how we are built and how we move. Some of us have legs that bow out (varus alignment) and others have knock knees (valgus alignment) which relates to the shape of our bone structure. It is a combination of our bony structure and how well our muscles work that can increase the likelihood of injury with running. This blog is looking at key areas of muscle weakness that alter our biomechanics and lead to injury. Your bony structure can’t be changed but improving your strength in the right areas can be achieved within 6 weeks of an exercise program that is designed for you. Assessing the biomechanics of the body combined with a basic understanding of your running style is important if you are serious about running.

A biomechanical physiotherapy assessment considers whether you have sufficient strength and mobility in the right places for running. The muscles in the back of the leg (calf, hamstring and gluteal) are important to maintain strength for running. Weakness in these muscles often leads to pain and injury in runners.

  • Calf muscle and Achilles tendon strength – it is important to understand that both muscles and tendons can respond to the loads we put on them. A simple test and exercise for the calf and achilles is the calf raise. If you can’t do a repeated full height single leg calf raise of more than 6 reps than you probably don’t have enough strength. I encourage people to get to 15 reps and be able to repeat 3 sets as a baseline but there isn’t a magic number here because it also depends on your running style. If you are about to change your style and get further forwards on the forefoot then check your calf and achilles strength first to minimise the chance of getting achilles tendon problems.

calf raise

  • Hamstring strength is essential for fast running but a base level of strength is also important for your park runners to 10km distances. Clearly the most functional way to strengthen the hamstrings for running is to gradually increase the distance and intensity of your running sessions. If you can’t do a hamstring bridge exercise or it takes considerable effort then you need to get stronger. Caution with doing this exercise – if it causes back pain then stop and discuss with one of our physio’s.

hamstring bridge

  • Gluteal (buttock muscle) strength allows for a stable pelvis during running. If you don’t have adequate gluteal strength it puts extra load on the knees, hips and lower back. Unless you have had a biomechanical physio assessment you probably don’t know if your glut’s are working well enough. A glute bridge is similar to a hamstring bridge but the knees are bent at approximately 90°. By bending the knees it makes it harder to use the hamstrings to lift the bottom and thus challenges the gluteal muscles more. Again if you have back pain stop and get some advice.

glute bridge

  • A squat is another good exercise to get the glute muscles working for runners but it needs to be done correctly. Keeping the back straight and bending at both the knees and hips gets the gluteal muscles working. Once you have been taught to do a squat correctly the challenge is a single leg squat with letting the knee drop in valgus collapse.

Squat exercise

Hope you have enjoyed reading about good strength exercises for runners. Thanks to Pete for his stick figure art which has been enjoyed by his clients for many years.